Internet-Addicted Kids and South Korean Government Efforts: Boot-Camp Case

Effectiveness of brief online mindfulness-based intervention on different types of mobile phone addiction: mechanisms of influence of trait mindfulness

Introduction

It is common for college students to suffer from mobile phone addiction, which can seriously affect their physical and mental health. The current study looked at the impact of a brief online mindfulness-based intervention (MBI) on mobile phone addiction to address this problem. The mechanisms behind the influence of trait mindfulness (TM) on this process were also investigated in the current study.

Methods

Subjects were split into two groups for a randomized controlled trial: an experimental group and a control group. During brief online MBI, online assessments of mobile social networking addiction (MSNA), mobile game addiction (MGA), mobile information acquisition addiction (MIAA), and mobile short-form video addiction (MSVA) as well as TM were completed. The present study examined the effectiveness of the brief online MBI with a two-factor repeated measures ANOVA and explored the effects of TM on the four types of mobile phone addiction with hierarchical linear modeling (HLM) after a brief online MBI.

Results

Results revealed that the experimental group receiving brief online MBI showed a significant decrease in MSNA, MGA, MIAA, and MSVA at the post-test level compared to the pre-test. TM negatively predicted MSNA, MGA, MIAA, and MSVA.

Discussion

The present study found that the brief online mindfulness-based intervention can effectively reduce four types of mobile phone addiction. In addition, the present study revealed that as the levels of TM increased, all four types of mobile phone addiction decreased.

Technology and addiction: What drugs can teach us about digital media

Comparisons between digital media and narcotic drugs have become increasingly common in the vigorous discussion on smartphone addiction and technology addiction. Commentators have used evocative terms such as "digital heroin," "electronic cocaine," and "virtual drugs" when discussing users' growing dependence on their devices. This article looks at the spreading discourse comparing digital media with drugs from a set of interdisciplinary perspectives including media studies, political economy, critical theory, science and technology studies, and addiction studies. It engages several key questions: To what extent can heavy smartphone use be considered an addiction, and how is it similar or different from drug addiction? How do the analogies between media and drugs fit within prevalent imaginaries of information technologies, and within the greater cultural themes and preoccupations of late capitalism? And finally, what can drugs teach us about the possible escape routes from our society's current predicament?

How Does Trait Mindfulness Weaken the Effects of Risk Factors for Adolescent Smartphone Addiction? A Moderated Mediation Model

As a psychological resource of individuals, trait mindfulness is valuable in facilitating individuals to maintain attention intensity, increase efficiency, and alleviate stress and depression. It can also buffer against the risk factors of addictive behaviors. However, applied research combining trait mindfulness and smartphone addiction with the use of psychological resources is relatively scarce and needs further examination. We constructed a moderated mediation model based on compensatory Internet use and conservation of resources theory (OCR) to examine the effects of social anxiety on adolescent smartphone addiction and to describe how trait mindfulness "works" and "in what contexts it works better". We analyzed 1570 adolescent subjects through a multistage stratified sampling method. Our findings revealed that social anxiety positively predicted smartphone addiction, while trait mindfulness was negatively associated with it. Furthermore, trait mindfulness mitigated smartphone addiction by reducing social anxiety, suggesting a mediating effect of social anxiety on this relationship. Meanwhile, the mediating effect was more pronounced among adolescents with left-behind experience; we found that left-behind experience partially moderated the relationship between social anxiety and smartphone addiction. Adolescents with left-behind experience had more significant compensatory media use with a higher risk of smartphone addiction. This study highlights the potential protective role of trait mindfulness in the development and maintenance of adolescent smartphone addiction. It provides empirical support for applying resource conservation theory and stress buffering theory in this context.

Increasing important roles of child and adolescent psychiatrists in the treatment of gaming disorder: Current status in Japan

Background

Digital gaming is the most common leisure activity among children and adolescents in Japan, especially in males. Playing online gaming has become more common among school-age children over the years. As a result, excessive online gaming in younger children has become a significant social problem in Japan. Previous studies have demonstrated that excessive online gaming could cause various mental health issues in children and adolescents. At medical institutions having child and adolescent psychiatry services, there is an increasing number of children and adolescents with various problems related to excessive gaming. The aim of this study was to investigate the current practice of gaming disorder (GD) in clinical settings in Japan.

Methods

The subjects of this study were all of 414 child and adolescent psychiatrists certified by the Japanese Society for Child and Adolescent Psychiatry (JSCAP). The study questionnaire was mailed to all subjects from the official secretariat of JSCAP. Study subjects were requested to answer the questionnaire anonymously. The survey contained three types of responses: open responses; single and multiple-choice responses; and, responses on a five-point Likert scale. The questionnaire consisted of 14 questions regarding GD.

Results

We received 159 responses. The most common reason for a visit to child and adolescent psychiatry service which results in a subsequent diagnosis of GD was school refusal/absenteeism followed by disruption of sleep-awake rhythm. The most common specialized treatment for GD currently offered at child and adolescent psychiatry service is individual psychotherapy. The two most frequently experienced difficulties in the treatment of GD were low motivation to achieve recovery and a large variety of combined problems other than excessive gaming itself. With regard to the three most common psychiatric comorbidities of GD, they were autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and depression.

Discussion

The results of our survey revealed that although GD is a behavioral addiction, many children and adolescents with GD first visit child and adolescent psychiatry clinics rather than specialized clinics for addiction which are usually designed and staffed for adult patients. Because it is known that GD is more prevalent among young males, including junior high and high school students, GD has become one of the most important clinical issues in child and adolescent psychiatry today. The important roles of child and adolescent psychiatrists in the treatment of GD has been increasing.

Effectiveness of a psychological growth camp without internet in the treatment of adolescents at risk of internet addiction: a pilot study

OBJECTIVE

This study aimed to investigate the effects of a psychological growth camp in the treatment of adolescents at risk of Internet addiction in Taiwan.

METHODS

We designed a psychological growth camp to treat adolescents at risk of Internet addiction. The CIAS (Chen Internet Addiction Scale) was used to assess the severity of Internet addiction at baseline, immediately after the camp, and at 1-month and 2-month follow-up visits.

RESULTS

A total of 16 participants were recruited, including 10 at risk of Internet addiction and 6 without the risk of Internet addiction. The results indicated that the participants not in a 2-parent family had significantly higher CIAS scores than those in a 2-parent family (p = .034). The participants at risk of Internet addiction exhibited significant improvements in total CIAS score at the time immediately after the camp (p = .033) and at 1-month (p = .001) and 2-month (p = .003) follow-up visits. Moreover, the incidence of possible Internet addiction was not significantly decreased immediately after the camp (p = .056) but was significantly decreased at 1- and 2-month follow-up visits (p < .05) compared with the baseline level. Otherwise, no significant improvements in total CIAS score or subscales were observed at the follow-up visits (p > .05) for the participants not at risk of Internet addiction.

CONCLUSION

The results indicate that the psychological growth camp without Internet might be effective in treating adolescents with Internet addiction.

The Comparative Efficacy of Treatments for Children and Young Adults with Internet Addiction/Internet Gaming Disorder: An Updated Meta-Analysis

Internet gaming disorder (IGD) is a formal mental disorder leading to bad outcomes for children and adolescents. This study comprehensively compared the estimated effect of various pharmacotherapy and psychosocial interventions for IGD from randomized controlled trials (RCT) through updated meta-analysis, using meta-regression. A search of PubMed/MEDLINE, Cochrane Library, and Airiti Library between 2000 and 2017 was conducted for various IA/IGD intervention modalities. A total of 124 studies from 29 selected papers involving 5601 children and young adults with IA/IGD were found. Meta-analyzing the pooled standardized mean difference (SMD) revealed a preliminary random effect of 1.399 with a 95% confidence interval of 1.272–1.527, suggesting highly effective treatment of IA/IGD. After adjusting for the confounding risks of age, publication year, type of subjects, and type of study, this study revealed that combining pharmacotherapy with cognitive behavioral therapy (CBT) or multi-level counseling (MLC) was the most effective treatment option. Using a scale of time spent online or a severity of IA symptoms scale was a more effective measurement, with p-values = 0.006 and 0.002, respectively. IA/IGD patients with comorbid depression showed worse outcomes than youth with another comorbidity. The corresponding model goodness-of-fit indices were τ² = 1.188; I²-Residual = 89.74%; and Adjusted-R² = 16.10%. This systematic review indicates that pharmacotherapy combined with CBT or MLC might be an effective therapeutic strategy for youth with gaming disorder.

Are Malaysian Youths Overdependent on the Internet?: A Narrative Review

Overdependence on the internet is a grave concern that has enveloped Malaysian youths which could lead to a variety of sequelae. This narrative review aims to determine the definition of internet overdependence and its associated factors, as well as the potential preventive and treatment strategies for internet overdependence. From the literature, internet overdependence is regarded as a 3-factor model encompassing salience, self-control failure, and serious consequences. Sociodemographic factors such as age, gender, and ethnicity, as well as psychosocial factors such as depression, anxiety, stress, and loneliness, were found to be associated with internet overdependence among Malaysian youths. A multimodal treatment approach is recommended by the implementation of various types of treatments, integrating disciplines such as pharmacology, psychotherapy, and family counseling. Despite various terminologies being used and unclear conceptualization of its nomenclature, overdependence on the internet is prevalent among youths in Malaysia. Future research should go toward establishing a clear definition of its terminology and attaining more robust evidence on treatment strategies.

How have excessive electronics devices and Internet uses been concerned? Implications for global research agenda from a bibliometric analysis

BACKGROUND AND AIMS

Excessive use of electronic devices has become a major global problem. However, little is known about the development and current landscape of research concerning this field. This study aimed at exploring the overall publication trend and topics of research on the overuse of electronic devices and the Internet from 1971 to 2017.

METHODS

We systematically searched the Web of Science (WoS) and Scopus databases for published articles on the excessive use of electronic devices and the Internet. Data regarding the publication volume, international collaborations, and geographical locations were analyzed by bibliometrics analysis. Latent Dirichlet Allocation (LDA) was undertaken to categorize publications into different research topics.

RESULTS

A total of 2,276 papers from the WOS and 600 papers from the Scopus were included. We found a dramatic increase in the number of scientific papers towards addiction to electronic devices and the Internet. The United State led in all publication parameters including the total number of papers and total citations. China, Korea and Taiwan were among the most prolific countries/regions. Smartphone addiction was the main concern, and the relationship between the overuse of electronic devices and the Internet and mental health issues have been highlighted. On the other hand, our study found a limited appearance of discussion on effective treatment and intervention.

DISCUSSION AND CONCLUSION

The findings of this study call for more national and international cooperation in evaluating and intervening addiction to electronic devices and the Internet to gather more knowledge about this phenomenon and evaluate the effectiveness of treatment.

[Current approaches to the treatment and correction of Internet addiction]

According to WHO consensus decision, gambling disorder, including the form of Internet addiction (IA), should be included in the section 'Impulsive disorders and behavioral addictions' of ICD-11. Population studies in the USA and Europe show the prevalence of IA from 1.5 to 8.2%, and in the countries of Southeast Asia it reaches 20-30% among young people. All this raises questions about the development of standardized approaches to the treatment and correction of this disorder. The review covers pharmacological and non-pharmacological approaches. Several studies and clinical observations have been devoted to pharmacological methods for treating IA, including the successful use of antidepressants such as escitalopram, clomipramine, and bupropion. There are data on the effectiveness of quetiapine, clonazepam, naltrexone and methylphenidate. In general, research was limited to methodological deficiencies, including small sample sizes, lack of control groups etc. Of non-pharmacological and psychotherapeutic approaches, in particular, cognitive-behavioral therapy (CBT) is the most studied. Special programs CBT are developed focused on children and teenagers. In addition to CBT, other psychotherapeutic approaches were used for the correction of IA: reality therapy, Internet interventions, acceptance and responsibility therapy, family therapy, complex methods. In many countries educational medical camps have been established (for example, sports or other outdoor activities) for adolescents with IA. Further studies in the field are needed to develop treatment approaches and diagnostic classification of IA.

Policy and Prevention Approaches for Disordered and Hazardous Gaming and Internet Use: an International Perspective

Problems related to high levels of gaming and Internet usage are increasingly recognized as a potential public health burden across the developed world. The aim of this review was to present an international perspective on prevention strategies for Internet gaming disorder and related health conditions (e.g., Internet addiction), as well as hazardous gaming and Internet use. A systematic review of quantitative research evidence was conducted, followed by a search of governmental reports, policy and position statements, and health guidelines in the last decade. The regional scope included the USA, UK, Australia, China, Germany, Japan, and South Korea. Prevention studies have mainly involved school-based programs to train healthier Internet use habits in adolescents. The efficacy of selective prevention is promising but warrants further empirical attention. On an international scale, the formal recognition of gaming or Internet use as a disorder or as having quantifiable harms at certain levels of usage has been foundational to developing structured prevention responses. The South Korean model, in particular, is an exemplar of a coordinated response to a public health threat, with extensive government initiatives and long-term strategic plans at all three levels of prevention (i.e., universal, selective, and indicated). Western regions, by comparison, are dominated by prevention approaches led by non-profit organizations and private enterprise. The future of prevention of gaming and Internet problems ultimately relies upon all stakeholders working collaboratively in the public interest, confronting the reality of the evidence base and developing practical, ethical, and sustainable countermeasures.

Association between use of internet and the cognitive function in older adults, populational longitudinal study EpiFloripa Idoso

OBJECTIVE

To estimate the association between the internet and the gain or loss cognite along of four years in older adults.

METHODS

Longitudinal study, a population-based, with older adults residents in a capital of southern Brazil (≥ 60 years) surveyed in 2009-10 (baseline) and in 2013-14 (follow-up). The outcome was assessed by clinically significant gain or loss of four or more points in the score of the Mini Mental State Examination between the two interviews. The use of internet was measured longitudinally (maintained or not internet usage, stop use of internet, started using the internet, retained the use of internet). Odds Ratios (OR) were estimated adjusted for sex, age, household income, education level and cognitive screening at baseline.

RESULTS

Respondents were 1.705 older adults in 2009-10 and 1.197 in 2013-14. There was a significant association between keep using internet and cognitive performance, with greater chance of cognitive gain (OR= 3.3; 95%CI 1.1 - 9.8) and lower cognitive impairment (OR = 0.39; 95%CI 0.17 - 0.88) for older adults who kept using the internet.

CONCLUSION

Older adults who continue using the internet were more likely to gain significant cognitive and lower cognitive loss. Topromote the internet use in older adults can help a strategy for cognitive stimulation in older adults.

Policy responses to problematic video game use: A systematic review of current measures and future possibilities

BACKGROUND AND AIMS

Empirical research into problematic video game playing suggests that overuse might cause functional and psychological impairments for a minority of gamers. Therefore, the need for regulation in the case of video games (whether governmental or self-imposed) has arisen but has only been implemented in a few countries around the world, and predominantly in Asia. This paper provides a systematic review of current and potential policies addressing problematic gaming.

METHODS

After conducting a systematic search in the areas of prevention, treatment, and policy measures relating to problematic Internet and video game use, papers were selected that targeted problematic gaming policies (N = 12; six in English and six in Korean). These papers served as the basis of this review.

RESULTS

Policies were classified into three major groups: (i) policy measures limiting availability of video games (e.g., shutdown policy, fatigue system, and parental controls), (ii) measures aiming to reduce risk and harm (e.g., warning messages), and (iii) measures taken to provide help services for gamers. Beyond the attempt to classify the current and potential policy measures, the authors also tried to evaluate their efficiency theoretically and (if data were available) empirically.

DISCUSSION AND CONCLUSIONS

Overall, it appears that although several steps have been taken to address problematic video game playing, most of these steps were not as effective as expected, or had not been evaluated empirically for efficacy. The reason for this may lie in the fact that the policies outlined only addressed or influenced specific aspects of the problem instead of using a more integrative approach.

Factors associated with maintenance of the use of internet, EpiFloripa Idoso longitudinal study

OBJECTIVE

To describe the use of the internet and to identify the sociodemographic and health factors associated with changes in the use of the internet over four years in older adults participating in the Brazilian EpiFloripa Idoso study.

METHODS

This is a longitudinal home-based, population-based study with 1,197 older adults who live in the urban area of Florianópolis, State of Santa Catarina, Brazil. We applied a face-to-face interview. We describe the use of internet according to frequency, place, devices, and motives of the use of the internet. To identify factors associated with changes in the use of the internet, we categorized the outcome as: non-use of the internet, stopped using the internet, started using the internet, and kept using the internet. The independent variables were sex, age, family income, education level, family arrangement, marital status, presence of caregiver, paid work, and cognitive impairment screening. We used multinomial logistic regression with risk ratio (RR) estimates and their respective confidence intervals (95%CI).

RESULTS

The prevalence of the use of internet increased from 22.9% in 2009-2010 to 26.6% in 2013-2014. Of the total number of older adults who participated in the study, 7.5% started using the internet, 3.2% stopped using it, 19.1% kept their use, and 70.2% kept their non-use in the analyzed period. Of the older adults who used the internet, most used it every day or almost every day of the week, in their own home, on desktop or portable computers, mainly to send and receive messages, to search for information to learn or investigate something, to find information about goods and services, and to use news, social networking, and health information websites. The factors associated with the use of internet over four years were: being male (RR = 2.19, 95%CI 1.48-3.26), higher monthly family income (RR = 3.53, 95%CI 1.35-9.23), higher education level (RR = 2.64, 95%CI 1.57-4.43), and no presence of caregiver (RR = 0.08, 95%CI 0.02-0.31).

CONCLUSIONS

Although the use of the internet is increasing among older adults, most of the population is still digitally excluded, especially women with lower income and education level. Strategies that promote the digital inclusion of older adults should be stimulated, aiming to universalize the use of the internet, and they should take into account socioeconomic and gender inequalities.

Family factors in adolescent problematic Internet gaming: A systematic review

Background and aims Familial influences are known to affect the likelihood of an adolescent becoming a problem gamer. This systematic review examined some of the key findings in empirical research on family factors related to adolescent problem gaming. Methods A total of 14 studies in the past decade were evaluated. Family-related variables included: (a) parent status (e.g., socioeconomic status and mental health), (b) parent-child relationship (e.g., warmth, conflict, and abuse), (c) parental influence on gaming (e.g., supervision of gaming, modeling, and attitudes toward gaming), and (d) family environment (e.g., household composition). Results The majority of studies have focused on parent-child relationships, reporting that poorer quality relationships are associated with increased severity of problem gaming. The paternal relationship may be protective against problem gaming; therefore, prevention programs should leverage the support of cooperative fathers. Discussion The intergenerational effects of problem gaming require further attention, in light of adult gamers raising their children in a gaming-centric environment. Research has been limited by a reliance on adolescent self-report to understand family dynamics, without gathering corroborating information from parents and other family members. The very high rates of problem gaming (>10%) reported in general population samples raise concerns about the validity of current screening tools. Conclusions Interventions for adolescents may be more effective in some cases if they can address familial influences on problem gaming with the active co-participation of parents, rather than enrolling vulnerable adolescents in individual-based training or temporarily isolating adolescents from the family system.

Functional impairment matters in the screening and diagnosis of gaming disorder

This commentary responds to Aarseth et al.'s (in press) criticisms that the ICD-11 Gaming Disorder proposal would result in "moral panics around the harm of video gaming" and "the treatment of abundant false-positive cases." The ICD-11 Gaming Disorder avoids potential "overpathologizing" with its explicit reference to functional impairment caused by gaming and therefore improves upon a number of flawed previous approaches to identifying cases with suspected gaming-related harms. We contend that moral panics are more likely to occur and be exacerbated by misinformation and lack of understanding, rather than proceed from having a clear diagnostic system.

Treatment and risk factors of Internet use disorders

Recently, many young people have developed Internet use disorders (IUD) as a result of the proliferation of Internet-enabled devices, leading to serious health and social problems worldwide. On occasion, medical and educational institutions, governments, and other groups have sought to take preventive action or treat IUD. In many cases, the preferred treatment for IUD is to set recommendations for appropriate Internet use. Reportedly, psychosocial therapies (including cognitive behavioral therapy, family therapy, and compound therapy) for IUD and pharmacotherapies (including antidepressant drugs and psychostimulants) for comorbid psychiatric or development disorders have been effective at reducing the degree and symptoms of IUD. In some countries, treatment camps have been developed for adolescents with IUD, and preventive education (including lectures and group discussions) has been provided for general adolescents. Such efforts have been effective at reducing the average degree of IUD severity. Some future IUD risk factors (e.g. being male, suffering from attention-deficit hyperactivity disorder, and exhibiting deteriorating psychiatric symptoms) have begun to be identified. However, clinical studies, treatment, and preventive actions are insufficient for treating IUD and standard treatments and preventive systems have yet to be established. Educational and medical institutions, government, families, and others must take greater action and cooperate more effectively in order to treat or prevent IUD.

A Meta-Analysis of Treatment Interventions for Internet Addiction Among Korean Adolescents

This study comprehensively examined the effects of treatment interventions for Internet addiction among adolescents in South Korea through a meta-analysis. We analyzed 70 domestic master's theses and journal articles that reported on controlled studies and involved pre- and post-test analyses in the design. The dates of these publications fall between 2000 and 2015. The total effect size, calculated by random-effect analysis (g), revealed that interventions for the treatment of Internet addiction were effective (ES = 1.838). Meta-ANOVAs revealed differences between groups based on a theoretical model, intervention group size, and intervention duration. Integrative therapy produced larger effect sizes (ES = 2.794) compared to other treatment models such as cognitive behavioral therapy and reality therapy. Effect sizes for interventions, including nine to 12 people (ES = 2.178), were larger than those of interventions including more or fewer participants. Finally, treatment interventions that lasted 8 or more weeks revealed larger effect sizes (ES = 2.294) compared to shorter interventions. The study findings suggest directions for the development and effective operation of future Internet addiction interventions among Korean adolescents. Increasing the effectiveness of these interventions requires an integrative theoretical model, an intervention group size of nine to 12 participants, and a long-term intervention.

Treatment with the Self-Discovery Camp (SDiC) improves Internet gaming disorder

INTRODUCTION

Internet gaming disorder (IGD) is a novel behavioral addiction that influences the physical, mental, and social aspects of health due to excessive Internet gaming. One type of intensive treatment for IGD is the therapeutic residential camp (TRC), which comprises many types of therapies, including psychotherapy, psychoeducational therapy, and cognitive behavioral therapy. The TRC was developed in South Korea and has been administered to many patients with IGD; however, its efficacy in other countries remains unknown. We investigated the efficacy of the Self-Discovery Camp (SDiC), a Japanese version of a TRC, and the correlations between individual characteristics and outcome measures.

METHODS

We recruited 10 patients with IGD (all male, mean age=16.2years, diagnosed using the DSM-5) to spend 8 nights and 9days at the SDiC. We measured gaming time as well as self-efficacy (using the Stages of Change Readiness and Treatment Eagerness Scale, a measure of therapeutic motivation and problem recognition).

RESULTS

Total gaming time was significantly lower 3months after the SDiC. Problem recognition and self-efficacy towards positive change also improved. Furthermore, there was a correlation between age of onset and problem recognition score.

CONCLUSIONS

Our results demonstrate the effectiveness of the SDiC for IGD, especially regarding gaming time and self-efficacy. Additionally, age of onset may be a useful predictor of IGD prognosis. Further studies with larger sample sizes and control groups, and that target long-term outcomes, are needed to extend our understanding of SDiC efficacy.

Psychometric properties of the 7-item game addiction scale among french and German speaking adults

BACKGROUND

The 7-item Game Addiction Scale (GAS) is a used to screen for addictive game use. Both cross cross-linguistic validation and validation in French and German is needed in adult samples. The objective of the study is to assess the factorial structure of the French and German versions of the GAS among adults.

METHODS

Two samples of men from French (N = 3318) and German (N = 2665) language areas of Switzerland were assessed with the GAS, the Major Depression Inventory (MDI), the Brief Sensation Seeking Scale, and the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ-50-cc). They were also assessed for cannabis and alcohol use.

RESULTS

The internal consistency of the scale was satisfactory (Cronbach α = 0.85). A one-factor solution was found in both samples. Small and positive associations were found between GAS scores and the MDI, as well as the Neuroticism-Anxiety and Aggression-Hostility subscales of the ZKPQ-50-cc. A small negative association was found with the ZKPQ-50-cc Sociability subscale.

CONCLUSION

The GAS, in its French and German versions, is appropriate for the assessment of game addiction among adults.

Withdrawal symptoms in internet gaming disorder: A systematic review

Internet gaming disorder (IGD) is currently positioned in the appendix of the DSM-5 as a condition requiring further study. The aim of this review was to examine the state of current knowledge of gaming withdrawal symptomatology, given the importance of withdrawal in positioning the disorder as a behavioral addiction. A total of 34 studies, including 10 qualitative studies, 17 research reports on psychometric instruments, and 7 treatment studies, were evaluated. The results indicated that the available evidence on Internet gaming withdrawal is very underdeveloped. Internet gaming withdrawal is most consistently referred to as 'irritability' and 'restlessness' following cessation of the activity. There exists a concerning paucity of qualitative studies that provide detailed clinical descriptions of symptoms arising from cessation of internet gaming. This has arguably compromised efforts to quantify withdrawal symptoms in empirical studies of gaming populations. Treatment studies have not reported on the natural course of withdrawal and/or withdrawal symptom trajectory following intervention. It is concluded that many more qualitative clinical studies are needed, and should be prioritised, to develop our understanding of gaming withdrawal. This should improve clinical descriptions of problematic internet gaming and in turn improve the quantification of IGD withdrawal and thus treatments for harmful internet gaming.

Internet Gaming Disorder in the DSM-5

The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes in its research appendix a potential new diagnosis-Internet gaming disorder. This article outlines the debate surrounding non-substance addictions and the rationale for including this condition in the "Conditions for Further Study" chapter in DSM-5 Section III. It also describes the diagnostic criteria that DSM-5 recommends and methods to assess Internet gaming disorder. The paper details international research related to prevalence rates, demographic, psychiatric, and neurobiological risk factors, the natural course of the condition, and promising treatment approaches. The paper concludes by describing important issues for research to address prior to official recognition of this condition as a mental disorder.

Factor Structure of the Internet Addiction Test in Online Gamers and Poker Players

BACKGROUND

The Internet Addiction Test (IAT) is the most widely used questionnaire to screen for problematic Internet use. Nevertheless, its factorial structure is still debated, which complicates comparisons among existing studies. Most previous studies were performed with students or community samples despite the probability of there being more problematic Internet use among users of specific applications, such as online gaming or gambling.

OBJECTIVE

To assess the factorial structure of a modified version of the IAT that addresses specific applications, such as video games and online poker.

METHODS

Two adult samples-one sample of Internet gamers (n=920) and one sample of online poker players (n=214)-were recruited and completed an online version of the modified IAT. Both samples were split into two subsamples. Two principal component analyses (PCAs) followed by two confirmatory factor analyses (CFAs) were run separately.

RESULTS

The results of principal component analysis indicated that a one-factor model fit the data well across both samples. In consideration of the weakness of some IAT items, a 17-item modified version of the IAT was proposed.

CONCLUSIONS

This study assessed, for the first time, the factorial structure of a modified version of an Internet-administered IAT on a sample of Internet gamers and a sample of online poker players. The scale seems appropriate for the assessment of such online behaviors. Further studies on the modified 17-item IAT version are needed.

Reliability and validity of the Korean version of the internet addiction test among college students

We developed a Korean translation of the Internet Addiction Test (KIAT), widely used self-report for internet addiction and tested its reliability and validity in a sample of college students. Two hundred seventy-nine college students at a national university completed the KIAT. Internal consistency and two week test-retest reliability were calculated from the data, and principal component factor analysis was conducted. Participants also completed the Internet Addiction Diagnostic Questionnaire (IADQ), the Korea Internet addiction scale (K-scale), and the Patient Health Questionnaire-9 for the criterion validity. Cronbach's alpha of the whole scale was 0.91, and test-retest reliability was also good (r = 0.73). The IADQ, the K-scale, and depressive symptoms were significantly correlated with the KIAT scores, demonstrating concurrent and convergent validity. The factor analysis extracted four factors (Excessive use, Dependence, Withdrawal, and Avoidance of reality) that accounted for 59% of total variance. The KIAT has outstanding internal consistency and high test-retest reliability. Also, the factor structure and validity data show that the KIAT is comparable to the original version. Thus, the KIAT is a psychometrically sound tool for assessing internet addiction in the Korean-speaking population.

Desensitization of Triggers and Urge Reprocessing for an Adolescent With Internet Addiction Disorder

This case study reports the successful treatment of Internet addiction in a 13- year-old male using four 45-minute sessions of the desensitization of triggers and urge reprocessing (DeTUR) protocol—an addiction protocol of eye movement desensitization and reprocessing (EMDR; Popky, 2005). This protocol uses EMDR procedures to process current triggers and positive future templates, but it does not identify or directly address any past trauma. At baseline, the participant showed a moderate level of Internet addiction (scoring 75 on Young’s Internet Addiction Test [IAT]) and moderate depression (26 on the Beck Depression Inventory [BDI]). During assessment, he identified 7 triggers for Internet gaming and rated the associated urge to engage in the activity with scores of 3–9 on the level of urge scale (0 = lowest, 10 = strongest). Using the DeTUR protocol, the level of urge for each trigger was reduced to 2, which the participants defined as “not being able to think about or crave for the game.” After treatment, his symptoms had declined to nonclinical levels (38 on IAT and 6 on BDI) and he was able to restrict his time on the Internet to an hour per day. These therapeutic gains were maintained at 6- and 12-month follow-up. The DeTUR may be a good treatment option for Internet addiction and further controlled studies are needed.

Assessing clinical trials of Internet addiction treatment: a systematic review and CONSORT evaluation

Although there is ongoing debate concerning the clinical status of Internet addiction, and the quality of the extant literature in this emerging field is not optimal, several clinical trials of both pharmacological and psychological treatments for Internet addiction have been published in recent years. A systematic review investigating the reporting quality of eight treatment studies is presented. Reporting quality was defined according to the 2010 Consolidating Standards of Reporting Trials (CONSORT) statement. An evaluation of the reviewed studies highlighted several key limitations, including (a) inconsistencies in the definition and diagnosis of Internet addiction, (b) a lack of randomization and blinding techniques, (c) a lack of adequate controls or other comparison groups, and (d) insufficient information concerning recruitment dates, sample characteristics, and treatment effect sizes. It is concluded that improvements in future studies' design and reporting would be of significant benefit to both researchers and clinicians, and to the overall positioning of Internet addiction in the behavioral addiction field.